Drug Utilization Evaluation of Systemic Antifungals in a Tertiary Care Hospital

Abstract

Introduction: The incidence of Invasive Fungal Infection has increased, and it constitutes a serious threat to human health and life, especially in immunocompromised and critically ill patients. We aimed to evaluate the appropriateness of antifungal agents along with their risk factors and sensitivity pattern. Methods: It is a retrospective, cross-sectional study, which includes details of patients prescribed with systemic antifungal agents during a period of five years (01-06-2016 to 31-05-2021). Collected details were compared with Infectious Diseases Society of America (IDSA) guidelines and mycological results to determine the overall appropriateness. Results: A total of 102 patients prescribed with systemic antifungals were selected for the study. The majority of the drugs were prescribed as Definitive (59.19%) and T Fluconazole (39.4%) was the most common drug given. The most common indication for antifungal prescriptions was found to be Respiratory tract infection. Appropriateness of antifungal use was assessed on indication, dosage, contraindication, and drug-drug interaction. Overall assessment of antifungal agents and treatment strategy demonstrated that antifungal treatment was appropriate in 41.6% cases, debatable in 36% cases and inappropriate in 22.4% of cases. The most common culture specimen collected was urine and Candida tropicalis (42.86%) was the frequently separated organism from it. Sepsis (21.4%) was the most common risk factor associated with invasive fungal infection. Conclusion: By implementing an effective antifungal stewardship program, we could improve the rational use of systemic antifungals and thereby prevent the future resistance and improve clinical outcome.